Article in Japanese

Clinical characteristics of viridans group streptococci bacteremia in pediatric hematology and oncology patients

Shun NAGASAWA¹⁾, Kotaro ARAKI^2,3), Kahoru FUKUOKA^2,3), Hiroshi HATAYA¹⁾, Yuho HORIKOSHI^2,3)

Although Viridans group streptococci (VGS) are low-virulent, normal oral microflora in humans, they can cause bacteremia in immunocompromised children. The aim of this study was to describe the clinical characteristics of VGS bacteremia in pediatric hematology and oncology patients.
Patients with VGS bacteremia, who underwent either chemotherapy and/or hematopoietic stem cell transplantation at the Division of Hematology and Oncology, Tokyo Metropolitan Children's Medical Center between January and December 2010, were enrolled into this study.
The most common underlying disease was acute myeloid leukemia in 16 patients (41%), followed by precursor B-cell acute lymphoblastic leukemia in ten patients (26%). Neutropenia was present in 37 patients (95%). Besides fever, nine patients experienced gastrointestinal symptoms (23%), and six patients experienced mucositis (15%). Cytarabine, in variable dosages, was used to treat 26 patients (67%). Cefepime was administered as empiric therapy to 37 patients (95%), with vancomycin added to treat 33 patients (85%) with a positive blood culture, due to possible cefepime-resistance. The VGS strain isolated most commonly was Streptococcus mitis in 19 patients (49%). Seven VGS strains were cefepime-resistant. All of the isolates were susceptible to vancomycin.

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1) Department of Pediatrics, Tokyo Metropolitan Children's Medical Center
2) Department of Infection Disease, Tokyo Metropolitan Children's Medical Center
3) Department of Immunology, Tokyo Metropolitan Children's Medical Center

Key words	viridans group streptococci bacteremia, bacteremia, pediatric hematology and oncology
Received	October 31, 2019
Accepted	March 5, 2020

32 (2)：102─108,2020